Afghanistan health sector shows strong progress: World Bank reports

The World Bank today announced the results of a review of progress achieved in the health sector in Afghanistan from 2002-2017. Conducted by World Bank experts and an independent group from the University of Toronto, the review found that many key health indicators had improved more rapidly in Afghanistan than in most other countries that had started at a similar level of development.

The under-5 mortality rate dropped 60 percent from 137 per 1,000 live births in 2002 to 55 in 2016. Births attended by skilled health personnel increased to 58 percent from 14.3 percent over the same period.

Announcing these results at a Presidential Summit on Health Care in Afghanistan, held today in Kabul, Dr. Timothy Evans, Senior Director for Health Nutrition and Population at the World Bank said, “The progress made in Afghanistan is impressive, especially given the serious security situation the country has faced over the last decade. Afghanistan has set a new benchmark against which to judge other countries affected by conflict, and even more so low income countries that are not facing conflict.”

These improvements are consistent with those observed in the quality of care and equity in access to services, and the large increase in the number of health facilities. The number of functioning health facilities increased five-fold over while the proportion of facilities with female staff increased from 22 percent to 87 percent. The review noted that the government’s contracting of nongovernmental organizations (NGOs) to provide health services has led to improvements in coverage and quality, even in provinces that had high levels of conflict, suggesting substantial resilience of the health care system.

Addressing the Summit after listening to the results, Mohammad Ashraf Ghani, President of the Islamic Republic of Afghanistan, emphasized that “modality of service delivery in partnership with NGOs that has significant progress on many fronts and proved remarkably resilient in the face of operational and security-related challenges. With support from development partners, we have come a long way in improving the health conditions of millions of Afghans.” He noted the importance of communicating these results in the health sector not only within Afghan society, but also, more importantly, to a wider audience around the globe.

While progress has been significant, there remains important health challenges. The review pointed out some of the remaining challenges the country faces. The use of family planning remains low, resulting in high fertility rates that could prevent Afghanistan from achieving its economic development goals. Malnutrition remains a serious problem that is exacerbated by declining levels of exclusive breast feeding and poor infant and child feeding practices. There is some controversy about the trend and level of the maternal mortality ratio (MMR), but there is widespread agreement that it remains unacceptably high. This may reflect the fact there are still parts of the country that are underserved. The quality of services in many public hospitals has stagnated at low levels.

Dr. Evans noted, “Afghanistan faces some difficult health challenges, but this is not the time for timidity. Rather it is the time to boldly build on the successes that have been achieved and invest sufficient resources, both domestic and international, to overcome these challenges.”